New Hope for Pediatric-onset Multiple Sclerosis

Multiple sclerosis diagnoses often occur between 20 and 40 years old. Early-onset multiple sclerosis, which occurs during childhood or adolescence accounts for less than 5% of all cases. Pediatric cases seem to be more inflammatory and aggressive than adult-onset multiple sclerosis and have a high relapse rate. Therefore, an important aspect of treating pediatric cases is to slow down disease progression as much as possible and prevent irreversible damage.

An increasing understanding of B cells in this disease as well as therapies that target B cells are giving hope in treating pediatric-onset multiple sclerosis. 

B cell depletion therapies are one growing area of study that use antibodies to target B cells and eliminate them from the body. While some of these therapies are in clinical trials, many have not reached pediatric clinical trials yet. Other emerging therapies include those that target specific B cell signaling pathways.

BAFF targeting therapy interferes with B cell activation and is widely used for other autoimmune diseases. However, these therapies seemed to increase inflammatory activity in a clinical trial, which was subsequently terminated.

Bruton’s tyrosine kinase inhibitors, which interfere with B cell activation and maturation, are currently undergoing multiple clinical trials.

Citation

Skarlis, C., Kotsari, M., & Anagnostouli, M. (2025). Advancing Treatment in Pediatric Multiple Sclerosis: The Promise of B-Cell-Targeting Therapies. International Journal of Molecular Sciences, 26(13), 5989. https://doi.org/10.3390/ijms26135989